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DHCF Releases Request for Proposals Seeking Health Plans for the Medicaid and Alliance Programs

Friday, November 2, 2012
Health Plans Sought for New Five-Year Contract Beginning May 1, 2013

(WASHINGTON, DC) – Today the District released a Request for Proposals (RFP) to solicit proposals from managed care companies that are interested in coordinating the delivery of health care services provided to District residents through the Medicaid and Alliance programs. The RFP will allow the Department of Health Care Finance (DHCF) to secure three health plans for a new five-year contract period beginning May 1, 2013.

“The companies that are selected for this program will have the significant responsibility of managing health care for more than one-quarter of the District’s total population,” said DHCF Director Wayne Turnage.  “Our interest lies in selecting health plans that offer innovative solutions to improving health outcomes for program beneficiaries, while mitigating the impact of those factors which have created growing cost pressures in the program.  We have reached a point where the direction of some of the metrics in our managed care program must be reversed.  Over the past few years we have witnessed a rise in avoidable hospital admissions, increases in patient hospital readmissions for the same illness within 30 days of the original treatment and rapidly growing emergency room expenditure rates for children.  These tendencies must be abated.”

Currently, DHCF spends more than $600 million on its managed care program for approximately 165,000 Medicaid and Alliance beneficiaries. The health plans that are selected will be required to meet quantifiable measures of network adequacy, enhanced case management requirements, program staffing standards, aggressive and innovative outreach objectives, improved hospital outcomes, and achieve certain performance standards.
DHCF is excited about the opportunity to invite new health plans to the Medicaid and Alliance programs.  The Office of Contracting and Procurement will manage the competitive procurement process and Director James D. Staton, Jr. anticipates that the responses to the RFP will be due no later than December 3, 2012. DHCF anticipates announcing the selection of the health plans in January 2013.  

Please refer to the Office of Contracting and Procurement website for additional information on the solicitation (www.ocp.dc.gov).